I have completed exit counseling for Direct Subsidized, Direct Unsubsidized, and Direct PLUS Loan borrowers. I
understand that I must repay my loan according to the terms of my promissory note.
Please return the completed form to:
UH Hilo Financial Aid Office
200 W. Kawili Street
Hilo, HI 96720-4091
OR as an email attachment to: uhhfao@hawaii.edu
XXX-
XX-
Name (Last, First, Middle Initial)
Last 4-Digits of SSN
Date of Birth
City, State, Zip Code
Email Address
Name (Last, First, Middle Initial)
Relationship
Phone No. (include area code)
Address
City, State, Zip Code
Email Address
Name (Last, First, Middle Initial)
Phone No. (include area code)
Address
City, State, Zip Code
Email Address
Name (Last, First, Middle Initial)
Phone No. (include area code)
Address
City, State, Zip Code
Email Address
BORROWER INFORMATION
CLOSEST LIVING RELATIVE
REFERENCE INFORMATION
Federal Direct Loans
Student Exit Contact Information
You must list two persons with different addresses who have known you for at least three (3) years.
References must have different addresses and telephone numbers.
Persons listed as a reference are not contractually bound in any way to the borrower and his/her loans.
To be completed by the UH Hilo Financial Aid Office.
Servicer: ___________________________________
___________________________________
___________________________________
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